ASTU/Ph.D./F.No.

/I
Sl. No. ........................

ASSAM SCIENCE AND TECHNOLOGY UNIVERSITY

GUWAHATI

APPLICATION FORM FOR ADMISSION INTO THE PH.D. PROGRAMME

Name of the Candidate

Department/Branch
Contact Number
Institution/College/
Organization
Address:

email
 ASTU/Ph.D./F.No./I

ASSAM SCIENCE AND TECHNOLOGY UNIVERSITY

GUWAHATI
Application form for admission into the Ph.D. Programme
1. Name of Candidate (In Block Letters)

2. A.S.T.U. Registration No. & Year (if any)

3. Father’s Name :

Mother’s Name :
4. Permanent Home Address

5. Address for Communication

6. Date of Birth:
7. Sex: Male/Female/Others :

8. Nationality

9. Category Gen SC ST OBC

10. Are you employed ? (If so, give details)
(Please furnish the N.O.C. from the
employer)

11. Have you qualified National Eligibility Test,

GATE etc. ? If so, give details.

12. Educational Information:

Examination Passed University/ College/ Year of Special Division/ Percentage/ Remarks
Board School Passing Subject Class CGPA

H.S.L.C.

H.S.S.L.C./P.U.
(Sc./Arts/Com.)

Bachelor Degree
( )

Masters Degree
( )
 M.Phil.

Others, if any
( )

(Self attested copies of mark sheets of all examination passed must be enclosed)

13. Place of Proposed Research Work (only at the Affiliated College/Recognised College)
Department
Laboratory
Faculty
(Engineering/Science/Management/Architecture/Pharmacy)
14. Proposed Field of the Research (in block letters):

(Please enclose 3 copies of Tentative Synopsis)

15. Name of two persons as referee with

contact address and telephone numbers:

DECLARATION
I hereby declare that information given above is correct and true to the best of my knowledge and
belief. If any of the information is found incorrect my candidature/application will be automatically
cancelled.

Date: ............................. Signature of the candidate

Note: The above form must be accompanied by a non refundable fee of Rs.1000/-(Rupees
One Thousand only) to be paid in the form of Demand Draft in favour of “Assam Science
and Technology University” payable at State Bank of India, AEC Branch, Branch Code-
010670, Guwahati, Assam, India,”
After selection of the candidate, the other fees will have to be paid by the candidate as
notified by the University from time to time.